Manual wheelchair users are at great risk for the development of upper extremity injury and pain. Any loss of upper limb function due to pain adversely impacts the independence and mobility of manual wheelchair users. There is growing theoretical and empirical evidence that fluctuations in movement (i.e., motor variability) are related to musculoskeletal pain. This perspectives paper discusses a local review on several investigations examining the association between variability in wheelchair propulsion and shoulder pain in manual wheelchair users. The experimental data reviewed highlights that the variability of wheelchair propulsion is impacted by shoulder pain in manual wheelchair users. We maintain that inclusion of these metrics in future research on wheelchair propulsion and upper limb pain may yield novel data. Several promising avenues for future research based on this collective work are discussed.